5 Best Probiotics for IBS according to a Nutritionist

Popularity of probiotics

Since May 2020, the number of Americans taking a probiotic has increased to 25%. The pandemic has been credited as probiotic bacteria are known for digestive health and immune support. Further, hundreds of randomized, placebo-controlled human clinical trials have shown that probiotics have efficacy for IBS, IBD, skin conditions, anxiety, depression, and more.

However, we healthcare professionals know most probiotics are not a one-size-fits-all and probiotics for IBS should initially be different strains then the popular lactobacillus acidophilus types.

Probiotics for IBS

As discussed in a previous article, Irritable Bowel Syndrome can be caused from SIBO (Small Intestinal Bacterial Overgrowth) and IMO (Intestinal Methanogen Overgrowth). This means these microbes are out of balance; there too many of them and adding more of them via probiotic will contribute to excessive hydrogen and methane production and that causes gas, bloating, reflux, diarrhea and constipation.

Sometimes, supplemented lactobacillus acidophilus (often combined with bifidiobacteria) probiotic strains can add to these overgrowths and contribute to overall IBS symptoms. This is also why adding fiber can exacerbate symptoms of IBS, fiber feeds which causes them to grow. Also, lactobacillus acidophilus make D-lactic acid and SIBO can already have an abundance of this metabolite. Specific IBS symptoms include gas and bloating and also brain fog.

While we use these probiotic strains in our practice, we tend to use herbal antimicrobials and other strains first to foster a balanced gut bacteria ecosystem.

It is important to note that researchers have theorized for quite some time that probiotics do not actually colonize the gut; instead, their effects are due to their ability to shift gut community dynamics and modulate the immune system whilst in transit.

Below is our list of beneficial bacteria that are generally well tolerated by IBS patients and in a lot of cases our first line of probiotic supplements for them.

Soil-Based Probiotic Strains (SBOs)

These probiotic strains come from soil and include Bacillus subtilis HU58™, Bacillus coagulans SC208, and Bacillus clausii SC109. A few interesting facts is that they do not need to be refrigerated and survive your stomach acid.

The belief around SBOs is that our digestive system would have gotten exposure to these specific probiotic strains from eating vegetables (before pre-washed produce was available in the grocery store) and historically we were much more connected

to nature - playing and having jobs outside.

These bacteria are special in that they create an environment that promotes other healthy bacteria to grow like Akkermansia muciniphila (keystone species), competitively exclude unfavorable microbes and support gut microbiota balance. Lastly, they create new compounds, such as B vitamins, vitamin K2, antioxidants and enzymes and bind to toxins for easier elimination.

Saccharomyces boulardii

Saccharomyces boulardii is a yeast that acts as a probiotic and works well in diarrhea-dominant situations like IBS-D and/ore traveler's diarrhea. It can maintain normal uptake of water and electrolytes during occasional diarrhea. This probiotic supplement is also beneficial to take during antibiotic treatment because it can prevent antibiotic-associated diarrhea, including diarrhea associated with antibiotic-induced Clostridium difficile overgrowth.

Saccharomyces boulardii may help maintain normal colonic populations of healthful Bifidobacteria probiotics (keystone species), crowd out potentially problematic organisms and support the body’s defenses against potential intestinal pathogens like H. Pylori. An increase stool concentrations of short-chain fatty acids that help nourish colon mucosal cells is one of the other health benefits. We generally use this as another first line of defense for our probiotic supplements.

Lactobacillus plantarum

Though a lactobacillus species, clinical research shows this probiotic works well for alleviating symptoms of chronic constipation (IBS C). The mechanisms through which probiotics affect gut motility and thus improving functional constipation symptoms are multifaceted and remain poorly understood.

A study found L. plantarum changes the gut microenvironment, including numerous biological processes and protein clusters relevant to GI motility. About 10 billion colony forming units seems to help.

Bifidobacterium

This is another keystone strain, a term that indicates they are the bacteria most responsible for a healthy digestive tract. Bifidobacterium infantis is one of the first beneficial bacteria that colonize the digestive system in babies.

Bifidobacteria are important producers of short chain fatty acids and important for

treating IBS. SCFAs feed intestinal cells and improve the gut health through a number of local effects, ranging from maintenance of intestinal barrier integrity mucus production, and protection against inflammation to reduction of the risk of colorectal cancer.

This strain has been successful at reducing subjective abdominal pain, bloating and fecal urgency in IBS sufferers. It's also been clinically proven to work "dead", even heat-inactivated bifidobacterium could alleviate symptoms of IBS.

Akkermansia mucinifilia

The last keystone strain, it’s the only strain that’s been identified that lives in the gut lining. It lives in that mucin layer of the gut lining, and it is responsible for regulating how thick or thin that mucin layer is, and therefore the integrity of your gut lining. So when you lose it, you lose the integrity of your gut lining, and now you have all these inflammatory issues. This is called intestinal permeability. In irritable bowel syndrome, inflammation can be contributing to overall symptoms. Clinical trials also show that this beneficial bacteria can support blood sugar regulation.

Probiotic Supplements VS Real Food

During a healing protocol for irritable bowel syndrome, we use both diet and specific probiotic supplement to induce the beneficial effects of recalibrating the digestive tract. We know exactly what to do based of a comprehensive stool test we order for you called GI Map by Diagnostic Solutions. We also may treat IBS with herbal antimicrobials to

further target harmful bacteria, detox and/or digestion dietary supplements. These are all unique to your test results and IBS symptoms. Generally we can reduce IBS symptoms like abdominal pain, bowel movements and more in as little as 2 weeks. You can see significant improvement in about 8 weeks. Some people alleviate symptoms in 8 weeks, others with severe IBS symptoms may need 12 weeks to relieve symptoms.

Once a protocol is complete, this is when we recommend multispecies probiotic supplementation with lactobacillus acidophilus in a once per day dose. This is in addition to daily intake of fermented foods.

Historically fermented foods was a way of food preservation and would have been part of a standard diet, now we have to make a conscious effort to include them. These plus eating a diet primarily of whole foods and in a relaxed state will help maintain a healthy gut in most clients.